Continuous Positive Airway Pressure (CPAP)

CPAP - Overview

Continuous positive airway pressure (CPAP) therapy is the frontline treatment for obstructive sleep apnea. CPAP therapy keeps your airway open during the night by gently providing a constant stream of air through a mask you wear while you sleep. This eliminates the breathing pauses caused by sleep apnea, so you will no longer snore or make choking noises in your sleep. You will be able to sleep through the night without your body waking up from a lack of oxygen.

When you use CPAP each night, you will feel more alert during the daytime. Your mood will improve and you will have a better memory. CPAP prevents or even reverses serious health problems linked to sleep apnea such as heart disease and stroke. Your partner may even sleep better because you will stop snoring.

CPAP comes with a machine, flexible tubing and a mask. Most machines are small – about the size of a tissue box – lightweight and relatively quiet. You can keep the CPAP machine on your nightstand or at the side of your bed.

The tubing connects the CPAP machine to your mask. The tubing is long enough to allow you to move around or turn over in your bed.

The CPAP mask may cover only your nose or both your nose and mouth. Another option is to use "nasal pillows," which fit in your nostrils. No matter what type of mask you use, it is important that it fits well and is comfortable. The mask must make a seal in order to keep your airway open through the night. A good mask seal will prevent air leaks and maintain the right level of air pressure.

Your sleep doctor will determine the amount of air pressure needed for CPAP to treat your sleep apnea. The doctor may recommend a CPAP titration study to calibrate your air pressure setting. Most CPAP units also come with a timed pressure “ramp” setting. This starts the airflow at a very low level, so you can fall asleep comfortably. The setting then slowly raises the pressure while you sleep until it reaches the right level to treat your sleep apnea.

CPAP is a lifestyle change. It works best when used every night, for the entire time you are sleeping. You also should use CPAP when you are napping. Just one night without the treatment can have a negative impact on your blood pressure. The more you use CPAP, the better you will feel.

CPAP - BenefitsHealth Risk PreventionCPAP can prevent or reverse serious consequences of obstructive sleep apnea. The treatment can help protect you from these serious health risks:

Heart diseaseBy treating your sleep apnea, you can reduce your risk of heart disease. Sleep apnea is linked to a variety of heart problems because it causes you to stop breathing many times each night. These breathing pauses cause changes in your blood pressure and can reduce your blood oxygen levels. This puts an enormous strain on your heart. People with untreated sleep apnea have a higher rate of death from heart disease than those without sleep apnea or with treated sleep apnea. Using CPAP therapy over an extended period of time can protect you from heart problems and reduce your chance of dying from them. These heart problems include:

Congestive heart failure

Coronary artery disease

Irregular heartbeat

StrokeIf you have sleep apnea, consistent CPAP use can reduce your risk of stroke, one of the leading causes of death and long-term disability. A stroke is a sudden loss in brain function. It occurs when there is a blockage or rupture in one of the blood vessels leading to the brain. People with untreated sleep apnea are two to four times more likely to have a stroke.

Motor Vehicle AccidentsCPAP can help you become a safer driver by reducing your daytime sleepiness. Untreated sleep apnea makes you more likely to be involved in a deadly crash. Many people with sleep apnea have a hard time staying awake and concentrating while driving.

Benefits to Your Health and Well-Being Using CPAP to treat your sleep apnea can improve your life and make each day better. It can help improve your:

Daytime AlertnessSleepiness and daytime fatigue are common symptoms of sleep apnea. CPAP can restore your normal sleep pattern and increase your total sleep time by eliminating breathing pauses in your sleep. This will help you wake up feeling more refreshed and boost your energy throughout the day.

ConcentrationUntreated, severe sleep apnea can damage your brain tissue. As a result you may have trouble concentrating. You also may suffer from memory loss. Using CPAP may improve your ability to think, concentrate and make decisions. This also can improve your productivity and decrease your chance of making a costly mistake at work.

SnoringBy keeping your airway open as you sleep, CPAP reduces or eliminates the sound of your snoring. While you may not notice, you bed partner will benefit from a quieter sleep environment.

Medical ExpensesBy improving your health, CPAP therapy can reduce your medical expenses. Sleep apnea can lead to more health problems and more doctors’ visits. Treatment for serious health risks linked to sleep apnea such as heart disease, stroke and diabetes can be costly. Medical expenses will decrease when you use CPAP to treat your sleep apnea.

CPAP - Side Effects

CPAP therapy has relatively minor side effects. Most of these problems can be fixed through simple adjustments:

Strap marks or skin soresThis side effect is often due to a poor mask fit. By readjusting or switching the type of mask that you use, you can eliminate these symptoms. You also should adjust your mask straps to make sure they are not too tight. It also may be helpful to buy soft CPAP strap covers to reduce the rubbing of the straps against your skin.

CPAP - VariationsTypes of PAP therapyThere are several forms of positive airway pressure (PAP) therapy other than CPAP. All forms of PAP therapy keep your airway open as you sleep by providing a stream of air through a mask that you wear:

BPAP Bilevel positive airway pressure (BPAP) devices have two alternating levels of pressure. When you breathe in air, the pressure rises. The pressure decreases as you breathe out. If you have a problem with CPAP or APAP, your sleep doctor may recommend BPAP. Your doctor also may recommend using BPAP if you have sleep apnea along with another breathing disorder.

Types of MasksThere are three common types of CPAP masks. No matter what type of mask you use, it is important that it fits well and is comfortable.Nasal mask This mask only covers your nose. This is the most common type of CPAP mask.

Full face maskThis mask covers both your nose and your mouth. This type of mask may help if you have air leaks when using a nasal mask.

Nasal pillows This mask uses soft silicone tubes that fit directly in your nose. This may help if you have air leaks or don’t like the feeling of a mask over your nose and face.

HumidifiersHumidifiers for CPAP can help reduce side effects from the treatment and make it easier for you to breathe through your mask. Some people may have nasal irritation or drainage from using CPAP. A humidifier can reduce these side effects by providing cool or heated moisture to the air coming from the CPAP unit. Many CPAP units come with a humidifier connected to the machine.

Tips for CPAPIt may take some time for you to become comfortable using CPAP therapy. Follow these tips to improve your quality of sleep with CPAP:

Begin using your CPAP for short periods of time during the day while you watch TV or read.This will help you get used to wearing your mask. It will feel more natural when you are trying to fall asleep.

Make CPAP part of your bedtime routine.Use CPAP every night and for every nap. Using CPAP less often reduces its health benefits and makes it more difficult for your body to adjust to the therapy.

Make small adjustments to increase your level of comfort.Adjust your mask straps and headgear until you get the fit right. You also can try using a special bed pillow that is shaped for a CPAP mask and tubing.

Make sure your mask is a good fit.The most common problems with CPAP occur when the mask does not fit properly.If the mask is too big, the straps holding it to your face will need to be pulled tightly. This may irritate your skin or lead to sores as the straps rub against your face. You also can buy soft CPAP strap covers to reduce the rubbing of the straps against your skin. A mask that is too small will not seal properly and air will leak out through the edges. The air may blow into your eyes. If you are having either problem, you may need a different mask or headgear.

If the pressure feels too high as you are trying to fall asleep, use the “ramp” mode on your CPAP unit.The ramp mode will start your device on a low pressure setting and gradually increase the pressure over time. You should be able to fall asleep before the air pressure reaches its proper level.

Use a saline nasal spray to ease mild nasal congestion.Nasal congestion can be a problem with CPAP treatment. A nasal spray or decongestant can help with nasal or sinus congestion.

Use a humidifier if you have a dry mouth, throat or nose.Many CPAP devices have a heated humidifier. It ensures that you are breathing warm, moist air through your mask.

Schedule a regular time to clean your equipment.Clean your mask, tubing and headgear once a week. Put this time in your schedule so that you don’t forget to do it.

If you are having problems remembering to use your CPAP every night, find someone to help.Consider joining a support group or asking someone you trust to hold you accountable for using your CPAP.

If these adjustments do not work, talk to the staff at your sleep center.The staff at your local sleep center are prepared to help you adjust to CPAP therapy. You may need a different type of CPAP mask or machine, or you may need an adjustment to your air pressure setting. Some people also benefit from cognitive-behavioral therapy. CBT can help you identify and overcome fears or concerns that may be preventing you from getting a good night’s sleep with CPAP.

If you think you may have sleep apnea or need CPAP, contact an AASM accredited sleep center near you.